scholarly journals The role of dietary calcium in bone health

2003 ◽  
Vol 62 (4) ◽  
pp. 851-858 ◽  
Author(s):  
Albert Flynn

Approximately 99% of body Ca is found in bone, where it serves a key structural role as a component of hydroxyapatite. Dietary requirements for Ca are determined by the needs for bone development and maintenance, which vary throughout the life stage, with greater needs during the periods of rapid growth in childhood and adolescence, during pregnancy and lactation, and in later life. There is considerable disagreement between expert groups on the daily Ca intake levels that should be recommended, reflecting the uncertainty in the data for establishing Ca requirements. Inadequate dietary Ca in early life impairs bone development, and Ca supplementation of the usual diet for periods of ≤3 years has been shown to enhance bone mineral status in children and adolescents. However, it is unclear whether this benefit is long term, leading to the optimisation of peak bone mass in early adulthood. In later years inadequate dietary Ca accelerates bone loss and may contribute to osteoporosis. Ca supplementation of the usual diet in post-menopausal women and older men has been shown to reduce the rate of loss of bone mineral density at a number of sites over periods of 1–2 years. However, the extent to which this outcome reduces fracture risk needs to be determined. Even allowing for disagreements on recommended intakes, evidence indicates that dietary Ca intake is inadequate for maintenance of bone health in a substantial proportion of some population groups, particularly adolescent girls and older women.

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zewei Shen ◽  
◽  
Canqing Yu ◽  
Yu Guo ◽  
Zheng Bian ◽  
...  

Abstract Summary In a Chinese population from both urban and rural areas, weight loss of ≥ 5 kg from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life. Introduction This study investigates the association of the long-term weight loss from young adulthood through the middle ages with the subsequent 10-year risk of hospitalized fracture and calcaneus bone mineral density (BMD). Methods China Kadoorie Biobank (CKB) was established during 2004–2008 in ten areas across China. Weight at age 25 years was self-reported at baseline, and weight at baseline and resurvey was measured by the calibrated equipment. Outcomes were hospitalized fracture during follow-up and calcaneus BMD measured at resurvey. Analysis for fracture risk included 411,812 participants who were free of fracture in the last 5 years before baseline, cancer, or stroke at any time before baseline. Analysis for BMD included 21,453 participants who participated in the resurvey of 2013–2014 with the same exclusion criteria as above. Results The mean age was 50.8 at baseline and 58.4 at resurvey. Median weight change from age 25 to baseline was 4.4 kg, with 20.7% losing weight and 58.5% gaining weight. During a median follow-up of 10.1 years, we documented 13,065 cases of first diagnosed fracture hospitalizations, including 1222 hip fracture. Compared with participants whose weight was stable (± 2.4 kg), the adjusted hazard ratios (95% CIs) for those with weight loss of ≥ 5.0 kg from age 25 to baseline was 1.39 (1.17 to 1.66) for hip fracture. Weight loss was not associated with fracture risk at other sites. Those with weight loss from age 25 to resurvey had the lowest BMD measures, with β (95% CIs) of − 4.52 (− 5.08 to − 3.96) for broadband ultrasound attenuation (BUA), − 4.83 (− 6.98, − 2.67) for speed of sound (SOS), and − 4.36 (− 5.22, − 3.49) for stiffness index (SI). Conclusions Weight loss from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life.


2004 ◽  
Vol 7 (1a) ◽  
pp. 227-243 ◽  
Author(s):  
A Prentice

AbstractObjective:To review the evidence on diet and nutrition relating to osteoporosis and provide recommendations for preventing osteoporosis, in particular, osteopototic fracture.Approach:Firstly, to review the definition, diagnosis and epidemiology of osteoporosis, to discuss the difficulties in using bone mineral density to define osteoporosis risk in a world-wide context and to propose that fragility fracture should be considered as the disease endpoint. Secondly, to provide an overview of the scientific data, the strengths and weaknesses of the evidence and the conceptual difficulties in interpreting studies linking diet, nutrition and osteoporosis. The following were considered: calcium, vitamin D, phosphorus, magnesium, protein and fluorine. Other potential dietary influences on bone health were also discussed, including vitamins, trace elements, electrolytes, acid–base balance, phyto-oestrogens, vegetarianism and lactose intolerance.Conclusions:There is insufficient knowledge linking bone mineral status, growth rates or bone turnover in children and adolescents to long-term benefits in old age for these indices to be used as markers of osteoporotic disease risk. For adults, the evidence of a link between intakes of any dietary component and fracture risk is not sufficiently secure to make firm recommendations, with the exception of calcium and vitamin D. For other aspects of the diet, accumulating evidence suggests that current healthy-eating advice to decrease sodium intake, to increase potassium intake, and to consume more fresh fruits and vegetables is unlikely to be detrimental to bone health and may be beneficial.


2009 ◽  
Vol 2009 ◽  
pp. 1-9 ◽  
Author(s):  
Rachel A. Kramer ◽  
Babette S. Zemel ◽  
Jessica L. Arvay-Nezu ◽  
Virginia A. Stallings ◽  
Mary B. Leonard ◽  
...  

Objectives. To assess bone health in a cohort of nonjaundiced children with biliary atresia (BA) and the effect of growth and development on bone outcomes.Methods. Children ages one to eighteen years receiving care from Children's Hospital of Philadelphia were recruited. Each child was seen once and assessed for growth, pubertal development, concurrent medications, bilirubin, ALT, albumin, vitamin D status, bone mineral density (BMD), and bone mineral content (BMC) of the lumbar spine and whole body.Results. BMD declined significantly with age, and upon further analysis with a well-phenotyped control cohort, it was found that BMC was significantly decreased for both lumbar spine and whole body, even after adjustment for confounding variables. An age interaction was identified, with older subjects having a significantly greater impairment in BMC.Conclusions. These preliminary results demonstrate that children with BA, including those without jaundice, are likely to have compromised bone health even when accounting for height and puberty, which are common confounding factors in chronic disease. Further investigation is needed to identify the determinants of poor bone mineral status and to develop strategies to prevent osteoporosis later in life.


2005 ◽  
Vol 64 (2) ◽  
pp. 193-203 ◽  
Author(s):  
Alexis M. Willett

Osteoporosis is an important contributor to the global burden of disease, and in the UK alone results in one in three women and one in twelve men aged >50 years experiencing a fragility fracture. Optimising peak bone mass in early adulthood is thought to reduce osteoporosis risk by offsetting bone losses in later life. Ensuring sufficient vitamin D status (measured as 25-hydroxyvitamin D (25OHD) in plasma), among other factors, is believed to facilitate the achievement of optimum peak bone mass. Lower 25OHD is associated with a higher plasma concentration of parathyroid hormone (PTH). As PTH is associated with increased bone turnover and bone loss, maintenance of sufficient 25OHD is thought to have a protective effect on bone health. However, there is a lack of consensus internationally on what constitutes an optimum 25OHD concentration, and values between 30 and 80 nmol/l have been suggested. These values have been based on findings from various studies in adults in which PTH has been observed to plateau at a 25OHD concentration of >30 nmol/l; however, not all studies have found such a plateau. Although studies in younger adolescents (14–16 years) have shown an inverse relationship between PTH and 25OHD, the concentration of 25OHD required for achievement of optimum peak bone mass is unknown. The present review examines the evidence defining vitamin D insufficiency thresholds, and the relevance of such thresholds to adolescent bone health.


2021 ◽  
Vol 11 (2) ◽  
pp. 710
Author(s):  
Ángel Matute-Llorente ◽  
Ángela Ascaso ◽  
Ana Latorre-Pellicer ◽  
Beatriz Puisac ◽  
Laura Trujillano ◽  
...  

The aim of this study was to evaluate bone health and body composition by dual-energy X-ray absorptiometry (DXA) in individuals with Cornelia de Lange Syndrome (CdLS). Overall, nine individuals with CdLS (five females, all Caucasian, aged 5–38 years) were assessed. Total body less head (TBLH) and lumbar spine (LS) scans were performed, and bone serum biomarkers were determined. Molecular analyses were carried out and clinical scores and skeletal features were assessed. Based on deep sequencing of a custom target gene panel, it was discovered that eight of the nine CdLS patients had potentially causative genetic variants in NIPBL. Fat and lean mass indices (FMI and LMI) were 3.4–11.1 and 8.4–17.0 kg/m2, respectively. For TBLH areal bone mineral density (aBMD), after adjusting for height for age Z-score of children and adolescents, two individuals (an adolescent and an adult) had low BMD (aBMD Z-scores less than –2.0 SD). Calcium, phosphorus, 25-OH-vitamin D, parathyroid hormone, and alkaline phosphatase levels were 2.08–2.49 nmol/L, 2.10–3.75 nmol/L, 39.94–78.37 nmol/L, 23.4–80.3 pg/mL, and 43–203 IU/L, respectively. Individuals with CdLS might have normal adiposity and low levels of lean mass measured with DXA. Bone health in this population seems to be less of a concern during childhood and adolescence. However, they might be at risk for impaired bone health due to low aBMD in adulthood.


Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 2106
Author(s):  
Fernanda Lima de Souza Castro ◽  
Woo K. Kim

Amino acids such as arginine, methionine, and cysteine are the precursors of essential molecules that regulate growth and health, being classified as functional amino acids. This review describes the metabolism of arginine and the sulfur amino acids and how they modulate, directly or indirectly, different tissues. Emphasis is placed on their effects in supporting health during challenging conditions, such as heat stress and Eimeria infection. The use of arginine has been shown to reduce abdominal fat pad in ducks and increase lean tissue and bone mineral density in broilers. Additionally, the sulfur amino acids have been shown to improve bone development and are beneficial during heat stress. The use of L-methionine increased the cortical and trabecular bone mineral densities, in laying hens. Moreover, the dietary inclusion of these amino acids could reduce the damage caused by Eimeria spp. infection by regulating the antioxidant system and cell repair. Understanding how these amino acids can mitigate stressful conditions may provide us novel insights of their use as nutritional strategies to modulate the health status of chickens.


Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1636
Author(s):  
Teresa Nestares ◽  
Rafael Martín-Masot ◽  
Carlos de Teresa ◽  
Rocío Bonillo ◽  
José Maldonado ◽  
...  

We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.


Author(s):  
Daniel G Whitney ◽  
Michelle S Caird ◽  
Gregory A ClineS ◽  
Edward A Hurvitz ◽  
Karl J Jepsen

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